https://sajp.co.za/index.php/sajp/issue/feedSouth African Journal of Physiotherapy2019-04-30T14:54:50+02:00AOSIS Publishingsubmissions@sajp.co.zaOpen Journal Systems<a id="readmorebanner" href="/index.php/sajp/pages/view/journal-information" target="_self">Read more</a> <img style="padding-top: 2px;" src="/public/web_banner.svg" alt="" />https://sajp.co.za/index.php/sajp/article/view/466Do physiotherapists have a role to play in the Sustainable Development Goals? A qualitative exploration2019-04-30T14:54:50+02:00Sholena Narainsholena@mweb.co.zaDesmond Mathyedesphysio@hotmail.com<p><strong>Background:</strong> While physiotherapists appear to be ideally positioned as key role players in achieving the health- and education–related Sustainable Development Goals (SDGs), few studies have examined the complete scope of physiotherapy practice in addressing the SDGS. Considering the broad scope of physiotherapy practice, physiotherapists are a valuable resource that the South African government can utilise to address their workforce shortages in achieving inclusive primary education, promoting gender equality, reducing child mortality, improving maternal health, and combating HIV and AIDS, and other diseases.</p><p><strong>Objectives:</strong> The aim of this study was to understand the roles of physiotherapists in the SDGs.</p><p><strong>Method:</strong> A qualitative, exploratory and descriptive approach was used. Semi-structured telephonic and Skype interviews were utilised to collect data from nine physiotherapists with PhDs working in academic institutions. Data were transcribed verbatim by the first author and verified by the second author. Data were entered into NVivo<sup>®</sup> Version 10. An inductive approach to qualitative data analysis was used. <em>In vivo</em> and open coding was used to generate codes and themes.</p><p><strong>Results:</strong> The following roles were highlighted: (1) address HIV and AIDS, tuberculosis and other chronic diseases of lifestyle; (2) improve maternal health; (3) reduce child mortality; (4) empower women and (5) achieve inclusive education for children, especially children with disabilities.</p><p><strong>Conclusions:</strong> Physiotherapists are well suited to address the SDGs of promoting gender equality and empowering women, reducing child mortality rates, improving maternal health, achieving inclusive primary education and combating HIV and AIDS, tuberculosis and other chronic diseases of lifestyle. Physiotherapists have a valuable role in addressing the quadruple burden of disease in South Africa and assisting the government with the current health resource crisis.</p><p><strong>Clinical implications:</strong> The results of this study will assist to move patient management from a more curative approach to health promotion and prevention. In addition, this study highlights the valuable role of physiotherapists in assisting and supporting the development agenda for ‘Transforming our world: the 2030 Agenda for Sustainable Development’.</p>2019-04-25T12:56:59+02:00Copyright (c) 2019 Sholena Narainhttps://sajp.co.za/index.php/sajp/article/view/469Intra-rater and inter-rater reliability of six musculoskeletal preparticipatory screening tests2019-04-30T14:54:50+02:00Nosipho Zumananosiphozumana@yahoo.comBenita Olivierbenita.olivier@wits.ac.zaLonwabo Godlwanalonwabogodlwana@yahoo.comCandice Martincandicephysio@gmail.com<p><strong>Background:</strong> High injury prevalence rates call for effective sports injury prevention strategies, which include the development and application of practical and reliable pre-participatory screening tools.</p><p><strong>Objectives:</strong> The aim of this study was to investigate the intra-rater and inter-rater reliability of the one-legged hyperextension test (1LHET), the empty can (EC) and full can (FC) tests, the standing stork test (SST), the bridge-hold test (BHT) and the 747 balance test (747BT).</p><p><strong>Method:</strong> Thirty-five healthy, injury-free male athletes (cricket and soccer players), aged 16–24 years, were evaluated by two physiotherapists. For each of the tests, the participants were evaluated twice (on two consecutive days) by each physiotherapist. Both the intra- and inter-rater reliability were determined. Cohen’s kappa (<em>k</em>) was calculated for the 1LHET, the EC and FC tests and the SST. The intraclass correlation coefficient (ICC) was used for the BHT and the 747BT. A confidence level of 95% (<em>p</em> ≤ 0.05) was applied as the criterion for determining the statistical significance of the results.</p><p><strong>Results:</strong> The SST presented with the lowest level of intra-rater agreement (ICC = –0.20 to 0.10). On the other hand, the EC test was the only test where one rater achieved an excellent intersessional agreement (<em>k</em> = 0.80; 95% confidence interval [CI] 0.40–1.20). Substantial to excellent results for the inter-rater agreement for both sessions were recorded for the 1LHET (<em>k</em> = 0.70–0.90) and the BHT (ICC = 0.70–0.90).</p><p><strong>Conclusion:</strong> Reliability values need to be considered when making clinical decisions based on screening tests. A more refined description of the testing procedures and criteria for interpretation might be necessary before including the six screening tests investigated in this study in formal screening protocols.</p><p><strong>Clinical implication:</strong> Confirmed reliability of screening tests would enable sports professionals to make informed decisions when designing preparticipatory musculoskeletal screening tools and when dealing with the management of injury risks in athletes.</p>2019-04-24T12:48:15+02:00Copyright (c) 2019 Nosipho Zumana, Benita Olivier, Lonwabo Godlwana, Candice Martinhttps://sajp.co.za/index.php/sajp/article/view/465A novel approach to improve hamstring flexibility: A single-blinded randomised clinical trial2019-04-30T14:54:50+02:00Faris Alshammarifalshammari@llu.eduEman Alzoghbiehzogbiah@yahoo.comMohammad Abu Kabarmohammadak2006@yahoo.comMohannad Hawamdehmohannadhawamdeh@hu.edu.jo<p><strong>Background:</strong> The hamstrings play a major role in body posture. Shortening or tightness of the hamstrings affects postural alignment and results in possible musculoskeletal pain.</p><p><strong>Objectives:</strong> The aim of this study was to develop a novel approach to improve hamstring flexibility in young adults.</p><p><strong>Method:</strong> A single-blinded randomised clinical trial included 60 participants aged 18–24 with shortened hamstrings recruited from the Hashemite University, Zarqa, Jordan. The range of motion of knee extension was measured with the hip at 90° flexion using a simple goniometer to detect the level of hamstring flexibility. Participants received either a passive hamstring stretch (PS), followed by two sets of 10 tibial nerve neurodynamic technique (ND), or PS followed by three sets of 10 repetitions of active knee extension–quadriceps activation (QA), or PS only.</p><p><strong>Results:</strong> There was a significant improvement of hamstring flexibility in the QA group compared to the PS group (13.4 ± 12.1° vs. 6.2 ± 6.4°, <em>p</em>= 0.05). There was a significant improvement in hamstring flexibility post-intervention compared to pre-intervention in the PS group by 6.2 ± 6.4 (30.5 ± 10.8° vs. 36.6 ± 9.5°, <em>p</em> = 0.001), ND group by 9.3 ± 6.2 (26.7 ± 10.9° vs. 36.0 ± 9.5°, <em>p</em> = 0.001) and QA group by 13.4 ± 12.1 (20.3 ± 9.0° vs. 33.4 ± 8.9°, <em>p</em> = 0.001).</p><p><strong>Conclusion:</strong> Quadriceps muscle activation following passive stretching of the hamstrings appears to be superior to the PS and ND techniques in improving hamstring muscle flexibility.</p><p><strong>Clinical implications:</strong> Quadriceps activation following passive hamstring stretching can be used in physiotherapy settings to improve hamstring muscle flexibility.</p>2019-04-23T11:28:31+02:00Copyright (c) 2019 Faris Alshammari, Eman Alzoghbieh, Mohammad Abu Kabar, Mohannad Hawamdehhttps://sajp.co.za/index.php/sajp/article/view/468Perceptions of physiotherapy clinical educators’ dual roles as mentors and assessors: Influence on teaching–learning relationships2019-04-30T14:54:50+02:00Ilse S. Meyerimeyer@sun.ac.zaAlwyn Louwajnlouw@sun.ac.zaDawn Ernstzendd2@sun.ac.za<p><strong>Background:</strong> Central to clinical education is the teaching–learning (T-L) relationship that evolves between the clinical educator (CE) and the student. Within this T-L relationship, CEs may be expected to fulfil dual roles as mentors and assessors of students. Challenges for both parties may arise when CEs take on these different roles.</p><p><strong>Objectives:</strong> The goal of this study was to ascertain how CEs perceived the influence of their dual roles as mentors and assessors on their T-L relationships with physiotherapy students.</p><p><strong>Method:</strong> Individual interviews were semi-structured with nine CEs during this qualitative descriptive study at the Division of Physiotherapy, Faculty of Medicine and Health Sciences, Stellenbosch University. A content analysis followed to analyse the data obtained. An iterative process, aimed to understand the phenomena under study, was conducted via an interpretive approach in context. This revealed main themes that were identified and refined.</p><p><strong>Results:</strong> Clinical educators experienced challenges when their role changed from being a mentor to that of assessor. These challenges affected the learning of students, as they influenced the T-L relationship. Clinical educators experienced ambiguities regarding their dual roles and, as a result, their expectations were often not fulfilled.</p><p><strong>Conclusion:</strong> Students’ learning processes were negatively affected by the changing roles of CEs, who acted as mentors and later as assessors of clinical competence during the students’ clinical rotations. The positioning theory was offered as a framework to resolve the challenges created by the dual roles and to manage expectations between CEs and students. The T-L encounters could be enhanced if students and CEs aligned themselves to a learning-centred paradigm where the focus was on learning and where the needs of the diverse students and the expectations of CEs were balanced. Further research should explore how a workshop with role play, demonstrating to CEs in practice how to reposition themselves, would impact the relationships between both parties.</p><p><strong>Clinical implications:</strong> It is essential to ensure a positive T-L relationship between a CE and a student as this will improve the quality of learning in the clinical environment and, therefore, directly influence student’s patient management. Implementing faculty development programmes to address this, should be further explored.</p>2019-03-28T09:30:39+02:00Copyright (c) 2019 Ilse S. Meyerhttps://sajp.co.za/index.php/sajp/article/view/467An injury profile of basketball players in Accra, Ghana2019-04-30T14:54:50+02:00Jonathan Quarteyneeayree@googlemail.comSetordzor F. Davorbsetordzor@yahoo.comSamuel K. Kwakyekwamed88@gmail.com<p><strong>Background:</strong> Basketball is played in Ghana at amateur and professional levels. The demands (cardiovascular, musculoskeletal and metabolic capacity) of the game place players at risk of sustaining injuries. There is a dearth of evidence of injuries sustained during basketball games in Ghana.</p><p><strong>Objectives:</strong> The aim of this study was to determine the injury profile of Ghanaian basketball players.</p><p><strong>Method:</strong> This observational cross-sectional study was conducted at the Lebanon House and Prisons courts during the 2013 Greater Accra Basketball league for Division 1 and 2 male basketball teams. Injuries were recorded according to body part injured, causes of injury, player’s ability to return to play following an injury, type of injury and treatment received using a standardised injury report form and data capturing form. Twenty-eight league competitions and 28 training sessions were observed. Data were analysed using a <em>Z</em>-test for two proportions.</p><p><strong>Results:</strong> Seventy-five injuries were recorded and the injury incidence was 0.190 and 0.084 per 100 participants during competition and training, respectively. Tackling attempts (42.67%) were the most common causes, followed by others (30.67%), which were dribbling, landing from a jump, sudden stops and jumping. Sprain (28%) was the most common injury. Knee injuries (21.33%) were more common than ankle injuries (17.33%). Out of the total injuries recorded, 85.33% did not receive any treatment.</p><p><strong>Conclusion:</strong> Knee injuries were the most common and most injuries did not receive treatment. It is therefore important to educate basketball players and coaches on injury prevention measures as well as developing regular exercise programmes to help minimise their occurrence.</p><p><strong>Clinical implications:</strong> Basketball injuries appear to be common so the outcomes of this study may provide prophylactic interventions and more focussed treatments regimens for basketball injury incidences in Accra.</p>2019-03-27T12:38:54+02:00Copyright (c) 2019 Jonathan Quartey, Setordzor F. Davor, Samuel K. Kwakyehttps://sajp.co.za/index.php/sajp/article/view/933Dysfunction, activity limitations, participation restriction and contextual factors in South African women with pelvic organ prolapse2019-04-25T12:57:29+02:00Corlia Brandtcorlia.brandt@wits.ac.zaElizabeth C. Janse van VuurenJanseVanVuurenEC@ufs.ac.za<p><strong>Background:</strong> Pelvic organ prolapse (POP) is a multifactorial, poorly understood condition impacting quality of life (QOL). The pathology and aetiology might imply population-specific differences in domains of the International Classification of Function, Disability and Health (ICF). There is, however, a lack of research in this regard in South Africa.</p><p><strong>Objectives:</strong> To describe the dysfunction, activity limitations, participation restrictions and contextual factors in South African women with POP.</p><p><strong>Method:</strong> One hundred women were conveniently sampled in a primary health care setting. They completed a self-compiled medical and exercise history questionnaire, the standardised Prolapse-Quality of Life (P-QOL) questionnaire and the Visual Faces Scale. The stage of prolapse was determined by the Pelvic Organ Prolapse Quantification (POP-Q) Scale. Means, medians, standard deviations, percentages and frequencies were calculated.</p><p><strong>Results:</strong> Eighty-six per cent had a stage III POP, 57% had overactive bladder, 50% had constipation, 37% had stress urinary incontinence, 31% had urge urinary incontinence, 32% had incomplete emptying and 30% had anal incontinence. Comorbidities included cardiovascular disease (65%), depressive symptoms (12%) and hypothyroidism (18%). Other contextual factors included limited physical activity (80%), an increased body mass index (29 kg/m<sup>2</sup>), older age (59 years) and unemployment (80%). Quality of life was affected in the severity, social, emotional and sleep/energy domains (median scores were 66.7% – 33.3%).</p><p><strong>Conclusion:</strong> The dysfunction domain of the ICF was similar to other populations with POP. Activity and participation restrictions included social, emotional and sleep/energy aspects. Contextual factors seem to be population-specific, possibly leading to differences comparing QOL amongst different populations.</p><p><strong>Clinical implications:</strong> Activity and participation restrictions, as well as contextual factors, may differ in different populations with POP. Interactions between contextual factors and movement impairment should be considered during management and be further investigated.</p>2019-02-28T11:25:49+02:00Copyright (c) 2019 Corlia Brandt, Elizabeth C. Janse van Vuurenhttps://sajp.co.za/index.php/sajp/article/view/461The effect of the Hambisela programme on stress levels and quality of life of primary caregivers of children with cerebral palsy: A pilot study2019-04-25T12:57:29+02:00Tamryn van Aswegentami.van.aswegen@gmail.comHellen MyezwaHellen.Myezwa@wits.ac.zaJoanne PottertonJoanne.Potterton@wits.ac.zaAimee StewartAimee.Stewart@wits.ac.za<p><strong>Background:</strong> Caregivers of children with cerebral palsy (CP) are at risk of having high stress levels and poor quality of life (QOL) which could have a detrimental effect on themselves and their children. Taking caregivers’ well-being into consideration is therefore important when providing rehabilitation to children with CP. Interventions to mediate primary caregiver stress and QOL using an educational tool have not been tested in this population in South Africa.</p><p><strong>Objectives:</strong> The aim of this study was to determine the effect of a group-based educational intervention, Hambisela, on stress levels and QOL of primary caregivers of children with CP in Mamelodi, a township in Gauteng, South Africa.</p><p><strong>Method:</strong> Eighteen primary caregivers of children with CP participated in a quasi-experimental pretest–post-test pilot study. Hambisela, a group-based educational intervention, was carried out once a week over 8 consecutive weeks. Caregiver stress and QOL were assessed before and after the intervention using the Parenting Stress Index-Short Form (PSI-SF) and the Paediatric Quality of Life-Family Impact Module (PedsQL<sup>TM</sup>-FIM). Sociodemographic information was assessed using a demographic questionnaire. The Gross Motor Function Classification System (GMFCS) was used to assess the gross motor level of severity of CP in the children.</p><p><strong>Results:</strong> Data were collected for 18 participants at baseline and 16 participants at follow-up. At baseline, 14 (87.5%) participants had clinically significant stress which reduced to 11 (68.8%) at follow-up. There was no significant change in primary caregiver’s stress levels (<em>p</em> = 0.72) and QOL (<em>p</em> = 0.85) after the Hambisela programme. Higher levels of education were moderately associated with lower levels of primary caregiver stress (<em>r</em> = −0.50; <em>p</em> = 0.03).</p><p><strong>Conclusion:</strong> Most primary caregivers in this pilot study suffered from clinically significant stress levels. Hambisela, as an educational intervention, was not effective in reducing the stress or improving the QOL in these primary caregivers of children with CP. Future studies with a larger sample size are needed to investigate the high stress levels of primary caregivers of children with CP.</p><p><strong>Clinical implications:</strong> Rehabilitation services for children with disabilities should include assessments to identify caregivers with high stress levels. Holistic management programmes should also include care for the carers.</p>2019-02-20T13:02:47+02:00Copyright (c) 2019 Tamryn van Aswegen, Hellen Myezwa, Joanne Potterton, Aimee Stewarthttps://sajp.co.za/index.php/sajp/article/view/472An International Classification of Function, Disability and Health (ICF)-based investigation of movement impairment in women with pelvic organ prolapse2019-04-25T12:57:28+02:00Corlia Brandtcorlia.brandt@wits.ac.zaElizabeth C. Janse van VuurenJanseVanVuurenEC@ufs.ac.za<p><strong>Background:</strong> There is little evidence on movement impairment of the abdominal and pelvic floor muscles (PFM) in women with pelvic organ prolapse (POP).</p><p><strong>Objectives:</strong> The aim of this study was to determine the movement impairments and interactions between the PFM and abdominal muscles in POP.</p><p><strong>Method:</strong> The PFM and abdominal muscles of 100 conveniently sampled South African women with POP were assessed by ultrasonography, electromyography (EMG), the PERFECT scale, Sahrmann scale and a Pressure Biofeedback Unit (PBU). A demographic questionnaire determined contextual factors (exercise and medical history) and Visual Faces Scale pain intensities. Data were analysed descriptively and with Spearman and Pearson correlation coefficients.</p><p><strong>Results:</strong> Participants (59 ± 9.31 years) were mostly unemployed (80%), physically inactive (85%), with comorbidities, heart or vascular disease, hypothyroidism and depression. The mean levator hiatus at rest (56.38 mm, standard deviation [SD] 9.95), thickness (5.1 mm, SD 1.41), amount of movement (4.28 mm, SD 6.84), strength (level 1.89, SD 1.13) and endurance (4.04 s, SD 3.32) of the PFM indicated dysfunction. Median values of zero were found for the Sahrmann scale (interquartile [IQ] range [0–1]) and PBU (IQ range [0–2]) and 10.95 µV for abdominal EMG (IQ range [7.9–17.8]). Pelvic floor muscle strength, endurance, movement and EMG activity correlation was fair (<em>r</em> &gt; 0.4, <em>p</em> &lt; 0.001), as was PFM strength, endurance and abdominal muscle function (<em>r</em> &gt; 0.4, <em>p</em> &lt; 0.05).</p><p><strong>Conclusion:</strong> Movement impairment of local and global stability and mobility functions of PFM and abdominal muscles was present, as well as correlations between these functions. Addressing these impairments may affect the identified contextual factors (socio-economic, psychological and lifestyle factors) and the possible activity limitations and participation restrictions in patients with POP. Further research is needed to investigate these interactions.</p><p><strong>Clinical implications:</strong> The findings suggest that assessment and management of patients with POP might need to be based on a comprehensive neuro-musculoskeletal assessment and a holistic approach. Standardised protocols for patients with pelvic floor dysfunction (PFD) should therefore be used with caution. Randomised controlled trials should investigate patient-specific and holistic intervention approaches.</p>2019-02-14T11:19:08+02:00Copyright (c) 2019 Corlia Brandt, Elizabeth C. Janse van Vuurenhttps://sajp.co.za/index.php/sajp/article/view/1325Table of Contents Vol 74, No 1 (2018)2019-04-30T14:54:50+02:00Editorial Officepublishing@aosis.co.za2018-12-14T00:00:00+02:00Copyright (c) 2018 Editorial Officehttps://sajp.co.za/index.php/sajp/article/view/1320Editorial: South African Journal of Physiotherapy 20182019-03-20T15:48:13+02:00Aimee V. Stewartaimee.stewart@wits.ac.zaNo abstract available.2018-12-11T13:28:22+02:00Copyright (c) 2018 Aimee V. Stewart